Article

Are Role and Gender Related to Sexual Function and Satisfaction in Men and Women Practicing BDSM?

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Abstract

Background: Published studies show good psychological health of people involved in bondage-discipline, dominance-submission, and sadism-masochism (BDSM) activities; nevertheless, there are few studies on characteristics related to gender, role in the BDSM scene, sexual functioning, and satisfaction among BDSM practitioners. Aim: The aim of this study was to explore gender and role differences, prevalence of sexual complaints, related distress, and sexual satisfaction in BDSM participants compared with the general population. Methods: A group of 266 Italian consensual BDSM participants (141 men and 125 women) were recruited with a snowball sampling technique. An anonymous protocol, including self-reported ad hoc and validated questionnaires, was used. The control group was composed of 100 men and 100 women who were not significantly different from the BDSM group for the sociodemographic data and were randomly extracted from an Italian database on sexual functioning of the general population. Main outcome measures: Self-reported demographic factors, including favorite and most frequent BDSM practices, the Sexual Complaint Screener, and the Sexual Satisfaction Scale, were completed by the participants. Results: The mean age of the BDSM group was 41.42 ± 9.61 years old (range 18-74). Data showed a varied outlook of practices, fantasies, rules, and roles. With regard to concerns about BDSM activities (fantasies and behaviors), participants reported a very low self-declared degree of distress. The dominant and switch groups appear to be more satisfied and less concerned about sexuality than the general population and the submissive group. Role in the BDSM scene was the only significant predictor of sexual satisfaction, showing a medium effect size. Clinical implications: Results from this study could be helpful to inform sexual health care professionals and to reduce the stigma related to the BDSM population. Strengths & limitations: In general, this study may help to describe better some characteristics related to gender, role, sexual preferences, function, and satisfaction. The main limitation regards the sampling method, which does not allow us to consider the group as representative of BDSM participants in general. Conclusion: Data showed a varied outlook of practices, fantasies, rules, and roles in both BDSM men and women. BDSM participants (especially dominant and switch groups) appear to be more satisfied and less concerned about sexuality than the general population. This is an attempt to increase the attention of researchers and health care professionals to this important topic and to improve the care provided to people with specific preferences and behaviors. Botta D, Nimbi FM, Tripodi F, et al. Are Role and Gender Related to Sexual Function and Satisfaction in Men and Women Practicing BDSM? J Sex Med 2019;16:463-473.

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... A few studies have systematically examined the relationship between kink behaviors and sexual behaviors. Most of these studies attempted to describe activities that people do as part of a kink scene 3 by using lengthy checklists of BDSM/kink/fetish behaviors (Botta et al., 2019;Moser & Levitt, 1987;Nordling et al. 2007;Rehor, 2015;Sandnabba, et al, 2002). These included inventories of lifetime or past-year prevalence of engagement in sexual acts; it is unclear whether many of these surveys specifically asked about sexual behaviors within the context of kink scenes. ...
... In terms of oral sex: 95.2% of the 1990s Finnish sample engaged in oral sex (Sandnabba et al., 2002); 91.73% of the 2016 Italian sample (Botta et al., 2019); 43.5% in the 1980s American sample of men (Moser & Levitt, 1987), and in the 2010 American sample of women, 95.41% received cunnilingus and 89.45% engaged in fellatio. In comparison, the lifetime prevalence of engaging in oral sex in a 2015 U.S. representative sample was 82.5% for women and 83% for men (Herbenick, et al. 2017). ...
... Penetrative sexual acts within the context of a BDSM scene or session occurred often or always over half the time (men=54.6%, women=63.2%) in a 2016 sample of 266 people from Italy who identified as BDSM practitioners (Botta et al., 2019). Pascoal et al. (2015) asked a sample of 68 people who identified as part of the kink/BDSM community in Lisbon, Portugal about their sexual satisfaction and level of distress about sexual dysfunctions both within a BDSM context This is a pre-print of an article published in the journal Sexualities. ...
Article
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Few studies have systematically examined the relationship between kink behaviors and sexual behaviors, yet even these preliminary studies indicate that the relationship is complex and that there is a notable diversity in how people construct the boundaries of sex and kink and the relationship between them. As part of a grounded theory study of kink identity, the current study examined how 70 kink-identified participants from Northern California discussed their experience and understanding of the relationship between kink and sex in interviews conducted in 2014 and 2015. Findings indicated seven themes: kink flowing into sex, kink as spice for sexual interactions, kink and sex as connection and intimacy, kink and sex as an expression of erotic energy, kink and sex as an expression of power exchange, kink as spiritual, and kink as freedom. Findings indicated that sexual orientation and gender identity may influence how people understand and experience the relationship between kink and sex.
... Given the nature of BDSM practices, we anticipate that students showing a proclivity for BDSM are likely to show a preference for more casual sexual relationships. Indeed, research has found that BDSM practitioners report engaging in 'play' dynamics with different people and with people with whom they may not necessarily be in a romantic relationship (Botta et al., 2019). In addition, there is a high overlap between BDSM engagement and those who practice consensual nonmonogamy (e.g., Swingers, polyamorous individuals; Bauer, 2010). ...
... Women in community samples and within the BDSM community, relative to men, tend to have more fantasies surrounding sexual submission and masochism and are also more likely to selfdescribe as holding a submissive role. In contrast, men are more likely than women to report sexually dominant and sadistic fantasies and to self-describe as holding a dominant role (e.g., Botta et al., 2019;Brown et al., 2019). However, results across studies are inconclusive regarding whether men or women engage in more BDSM behavior, and to our knowledge, research has yet to investigate potential differences in BDSM proclivity across college men and women (Brown et al., 2019). ...
... Reported sociosexual behaviors, however, were not related to either attitudinal or experiential BDSM proclivity. The current null finding supports the notion that those interested in BDSM are likely spread across a spectrum of those who may enjoy exploring and fantasizing about engaging in BDSM with a long-term partner and those who enjoy sexual experimentation both with casual sex partners and within the context of new sexual activities (Bauer, 2010;Botta et al., 2019;Carlström, 2017). ...
Article
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Bondage/discipline, dominance/submission, and sadism/masochism (BDSM) proclivity among college students is poorly characterized, in part because existing measures of BDSM proclivity highlight the consensual nature of BDSM and are appropriate for use with non-community members (e.g., those who may not understand BDSM jargon). The current study introduces such a measure, the BDSM Proclivity Scale, which characterizes BDSM proclivity among college students and evaluates relations of BDSM proclivity with other sexual attitudes and behaviors. College students (n = 552) completed measures of BDSM proclivity, sociosexual attitudes and behaviors, rape-supportive attitudes, lifetime sexual partners, and consent-seeking behavior. Two factors mapping onto attitudes and experiences related to BDSM were identified and cross-validated. Average endorsements of BDSM attitudes and experiences on a 7-point Likert scale (1 = strong disagreement, 7 = strong agreement) were 5.61 and 4.44, respectively. Structural models revealed that lifetime sexual contact and gender significantly positively correlated with BDSM attitudes and experiences, sociosexual attitudes positively correlated with BDSM attitudes, and rape-supportive attitudes positively correlated with BDSM experiences. Consent-seeking was unrelated to BDSM experiences or attitudes. College student BDSM proclivity was evident for both attitudes and experiences, highlighting the need to characterize the development of BDSM proclivity and its correlates, the sources of students’ knowledge, and the nature of students’ experiences. The observed associations between BDSM proclivity and relevant sexual attitudes and behaviors support its construct validity and suggest that BDSM proclivity may prove to be an important addition to the broader constructs assessed in sexual attitudinal and behavioral domains.
... Castellini et al. (2018), for instance, demonstrated that a link between m/s behaviors and psychopathology among female university students disappears after controlling for hypersexuality. BDSM practitioners, including practitioners of m/s, have, on average, obtained significantly higher levels of education than adults in the general population (Bienvenu et al., 2005;Botta et al., 2019;Breslow et al., 1986;Connolly, 2006;Gemberling et al., 2015;Levitt et al., 1994;Moser & Levitt, 1987;Sandnabba et al., 1999;Spengler, 1977;Taylor & Ussher, 2001;Wismeijer & Assen, 2013;Yost & Hunter, 2012). While higher education certainly does not prevent psychopathological symptoms (especially during the time it is being obtained, Hunt & Eisenberg, 2010), rates of major mental disorders are lower among adults who have university diplomas than among those who do not (e.g., ESEMeD/MHEDEA 2000Investigators et al., 2004. ...
... It is, however, interesting to note that sexually submissive persons report, on average, significantly more signs of psychological difficulties than those who are sexually dominant, although these difficulties occur at subclinical levels and are usually related to anxiety, worry, and self-esteem (Bienvenu et al., 2005;Botta et al., 2019;Connolly, 2006;Damon, 2001;Gemberling et al., 2015;Gosselin & Wilson, 1980;Hébert & Weaver, 2015;Wismeijer & Assen, 2013). Certain individuals also report that BDSM, and particularly m/s behaviors, have therapeutic effects (Easton, 2007;Graham et al., 2016;Lindemann, 2011). ...
... Those in the first subgroup are classically labeled "balancers" (Scott, 1985), as their main goal is to stop being responsible, to let go, in an erotic environment. Those in the second subgroup (whose basic preference is for sexual submission) resemble the general population in that there are significantly more women than men (Bienvenu et al., 2005;Botta et al., 2019;Castellini et al., 2018;Stiles & Clark, 2011;Wismeijer & Assen, 2013;Yost & Hunter, 2012). Indeed, women are much more likely than men to be sexually aroused by submissive behaviors, both in fantasy (see Leitenberg & Henning, 1995;Joyal et al., 2015 for reviews) and practice (Joyal & Carpentier, 2017;Jozifkova, 2018;Mundy & Cioe, 2019), at least in rich industrialized countries (where such studies are usually conducted). ...
Article
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A growing number of studies have demonstrated that BDSM (Bondage/Discipline-Domination/Submission-Sadism/Masochism) practices are not signs of mental illness. However, the reasons for engaging in such behaviors are not well understood, especially for sexual masochism or submission (m/s). A thorough review of the literature was conducted, as well as a search in Internet forums and an online survey to obtain testimonies that provide information on the origins of interest in m/s and the reasons for engaging in it. A qualitative content analysis was performed on narratives from 227 m/s practitioners. Sixteen themes emerged from this analysis, eight related to the origins of interest in m/s and eight to the reasons for engaging in m/s. The origins described were seen as either intrinsic or extrinsic. Reasons to engage in m/s were related to one of three main types of activities: use of interpersonal power; experiencing physical pain; and altering one’s state of mind. These results concord with accounts found in non-academic books and small-scale studies suggesting that m/s interests are often present early in life and usually practiced to reach an altered state of mind associated with sexual arousal. Possible reasons for choosing m/s over more common means of mind alteration are discussed.
... This does not appear to be the case for the BDSM community, where in one study of BDSM practitioners, only 65% identified as heterosexual, with 23% identifying as bisexual, and 17% identified their sexual orientation as something other than hetero-or bisexual (percentages exceed 100% because multiple choices were allowed) (Brown et al., 2017). In one study of BDSM practitioners (Botta et al., 2019), only 40% of men (n = 141) and 30% of women (n = 125) identified exclusively as heterosexual. Non-heterosexual individuals also practice BDSM more frequently than heterosexuals (De Neef et al., 2019). ...
... This also supported our expectation based on previous literature that nonheterosexual individuals would engage more often in BDSM activities compared with heterosexual individuals. As previous research has suggested, non-heterosexual individuals are highly represented in the BDSM community compared to heterosexual individuals and they practice BDSM more often (Botta et al., 2019;Brown et al., 2017;De Neef et al., 2019) . There are, to our knowledge, no current theories discussing why non-heterosexual Have you been dominated, humiliated, controlled (e.g. ...
Article
According to previous research, interest in BDSM (Bondage-Discipline, Dominance-Submission and Sadomasochism) activities is high in several European countries and various BDSM practices are not uncommon. There is a limited amount of research on the personalities of BDSM practitioners, but in previous research practitioners have been found to have better overall well-being and to be more educated than the general population. The current study explored the prevalence of BDSM interest and practice in a Finnish sample (n = 8,137, age range 18–60, M = 30.14, SD = 8.08) and investigated the association between BDSM interest and personality measured with the six-factor personality measure HEXACO. A total of 38% of the sample was interested in BDSM sex and non-heterosexual individuals displayed almost twice as much interest and at most 83% more participation in BDSM than heterosexual individuals. Younger participants (18–28 years old) displayed almost three times as much interest than older participants. There were some associations between BDSM interest and personality factors, but the effect sizes of these associations were modest. The study shows that BDSM interest is quite common among the Finnish population.
... Several treatments of male and female sexual dysfunction in sexual medicine have often put aside pleasure and satisfaction, favouring the primacy of function (Fahs, 2014;Grunt-Mejer, 2021;Levin, 2020). Moreover, clinicians may have prejudices against people with alternative erotic preferences and might feel uncomfortable and inadequate talking about clitoral stimulation, masturbation, female ejaculation, BDSM bondage-discipline/domination-submission/sadismmasochism), kinky practices and sex toys (Botta et al., 2019;Eichenberg et al., 2019;Hoff & Sprott, 2009;Jannini et al., 2012;Kolmes et al., 2006;Miranda et al., 2019). ...
... Common sex-negative assumptions about BDSM include beliefs that these behaviours are a result of traumatic experiences (especially in childhood) and that those who take on submissive roles are powerless and distressed. Scientific evidence has highlighted how BDSM practitioners inserted in a community where their fantasies and behaviours are accepted and shared reported higher sexual satisfaction and well-being than the general population (Botta et al., 2019). However, many people practicing kinky behaviours feel significant shame and distress related to the widespread stigma and vilification of the practices (Burnes et al., 2017;Yost & Hunter, 2012). ...
Article
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Introduction The Biopsychosocial model (BPS) represents a comprehensive paradigm of consolidated practices. Although it has been outlined as the gold standard in sexology, its implementation is often challenging. The sex-positive approach is a ground-breaking movement that is gaining popularity all over and is focused on the recognition of different sexual expressions as valid, consensual, healthy, and meaningful. However, a pragmatic implementation of this approach is still missing. Methods A critical review was conducted based on bibliographic research on Medline, PubMed, EBSCO, Cochrane Library, Scopus and Web of Science on relevant articles published from January 2011 to July 2021. Results A total of 116 papers were included in the following review, indicating an increasing body of research about BPS and sex-positive frameworks during the last 10 years. One of the main limitations in the BPS is the scarce attention paid to socio-cultural factors involved in sexual expressions, such as the role of negative attitudes towards sexuality that may affect health care professionals’ work. An application of the sex-positive approach to the BPS model may bring greater attention to the needs, values and desires of the individual, as well as allow a new knowledge and understanding of sexuality within a broader spectrum, including diversities and pleasures. Conclusions The sex-positive approach represents a viable path that entails the willingness of health care professionals to get involved actively; criticize their personal attitudes, beliefs, and knowledge about sex and work hard to improve their practice in sexology. Policy Implications A discussion of the possible fruitful integration between the BPS and the sex-positive approach is presented, highlighting practical applications in research, clinical practice, training and sex education and giving possible directions for future studies and policies.
... Kinky activities and BDSM (a variety of behaviors involving bondage, discipline, dominance, submission, sadomasochism, and other practices) could be good opportunities for exploring gender identity and sexual orientation. The BDSM community has been historically respectful of diversities and expressions [20]. Moreover, being inside a community can be an important supportive factor to contrast minority stress consequences such as shame, isolation, grief, and loss. ...
... Asexual BDSM practitioners seem to form non-sexual relationships based on affection and domination rather than fulfillment of sexual desire. For example, these people adapt BDSM practice to generate trust, courage, insight, self-discipline, power, and attunement in their relationships rather than sexual desire or pleasure [20,41]. ...
Article
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Purpose of Review The purpose of this review is to summarize the current knowledge on sexual desire expressions, sexual orientation, and identity in understudied groups inside the LGBT+ community. Recent Findings Sexual desire and related problems have unique expressions in LGBT+ people which influence their sexual health. Emerging sex-positive approaches might be powerful and prominent tools to provide support and education on behalf of safer sex practices and marginalized sexualities. The importance of deepening LGBT+ sexualities and relationships, not only in lesbian women and gay men but also in all the other shades of the rainbow (bisexual, transgender, asexual, fluid, and non-binary/genderqueer identities), is strongly highlighted. Summary A lack of literature regarding sexual desire in LGBT+ people is reported. Results are controversial and research is still limited on this topic, with little information available about sexual and health needs of sexual minorities beyond gay and lesbian people.
... Gay men in the BDSM community showed a high frequency of fantasies including leather outfits, wrestling, special equipment and uniform scenes, rimming, anal intercourse, and dildos [96]. BDSMers seem to be more satisfied and less concerned about sexuality than the general population [97]. Overall, it should be recognized how giving space to personal erotic fantasies, sharing and exploring them in a safe environment might have a positive outcome on sexual satisfaction and quality of life [96,97]. ...
... BDSMers seem to be more satisfied and less concerned about sexuality than the general population [97]. Overall, it should be recognized how giving space to personal erotic fantasies, sharing and exploring them in a safe environment might have a positive outcome on sexual satisfaction and quality of life [96,97]. ...
Article
Full-text available
Purpose of Review The purpose of this review is to summarize the current knowledge around sexual desire, fantasies, and related biopsychosocial factors that may facilitate or obstruct sexual expressions in lesbian women and gay men. Recent Findings Sexual desire levels and related problems do not seem significantly different in people who identify as gay or lesbian compared to their heterosexual counterparts. Evidence has shown lesbian women and gay men may have specific desire expressions and biopsychosocial factors influencing their sexual health. This may suggest the importance of deepening the understanding of the unique factors of LGBT+ sexuality and relationships while paying attention to the sociocultural background in which lesbian and gay people grow and develop their identities. Summary A lack of specific and unbiased literature on sexual desire and fantasies in gay and lesbian people is reported. Available evidence is controversial and often biased. LG people showed a variety of sexual expressions that are hard to categorize referring to the heteronormative sexual standards that permeate literature and clinical practice. Implications for future research and clinical practice are discussed.
... They found that, for some people, such activities are a central part of their sexual identity and for others they are common variations of their sexual fantasies and behaviors. 14 The new proposed definitions of paraphilic disorders in ICD-11 may have forensic relevance when the behaviors involved are described in criminal and penal legislation, or when the status of being diagnosed with a paraphilic disorder is potentially relevant to adjudication, sentencing, or criminal penalties. This paper reports on the results of an examination of the medicolegal implications of the proposed ICD-11 classification and diagnostic guidelines in Brazil. ...
Article
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Introduction: The World Health Organization (WHO) Department of Mental Health and Substance Abuse appointed a Working Group on Sexual Disorders and Sexual Health in order to revise and propose changes to ICD-10 categories. Aim: Analyze ethical and legal implications in Brazil of the proposed ICD-11 diagnostic criteria for paraphilic disorders. Methods: A forensic working group of Brazilian experts in collaboration with representatives of WHO reviewed the proposed modifications to the classification of Disorders of Sexual Preference in ICD-10 (F65), which is recommended to be replaced by Paraphilic Disorders in ICD-11. Proposals were reviewed through a medicolegal lens, using a legal and policy analysis guide put forth by WHO. The premise of this review was to understand that, although the ICD classification is intended to provide a basis for clinical and statistical health interventions, medical diagnostics may also be entangled in the complex legal, normative, and political environment of various countries. Main outcome measure: The most important proposed change to this section is to limit the concept of paraphilic disorders primarily to patterns of sexual arousal involving a focus on others who are unwilling or unable to consent, but this change has not affected the ethical and legal aspects of psychiatric functioning in the Brazil. Results: Because Brazilian criminal law is directed toward criminal behavior and not to specific psychiatric diagnoses, the changes proposed for ICD-11 are not expected to create obstacles to health services or to modify criminal sentencing. Clinical implications: Although ICD-11 has a number of changes in its content, there are no significant clinical implications in the Brazilian context, but a better clarity of conceptual definitions and diagnostic criteria. Strengths & limitations: The study is conducted with people from different Brazilian states, which is important for a comprehensive view. On the other hand, considering that it is a very heterogeneous country, there is the limitation that an even wider scope of the study is not possible. Conclusion: In the Brazilian context, the new guidelines for paraphilic disorders contribute to clinical utility and are not expected to create difficulties related to the legal, social, and economic consequences of sexual offenses in the country. Abdalla-Filho E, de Jesus Mari J, Diehl A, et al. Forensic Implications of the New Classification of ICD-11 Paraphilic Disorders in Brazil. J Sex Med 2019; XX:XXX-XXX.
... In this sense, opening a more in-depth discussion on BDSM and other sexual practices within the MSM community could be very helpful to avoid major harm and suggest these behaviors take place in situations in which a higher state of consciousness and vigilance are maintained. 4,19,32,33 Still unspoken but frequent are various forms of abuse that may occur in a context of altered consciousness such as chemsex. 34,35 We are not only referring to physical and sexual abuse, but also blackmail such as revenge porn. ...
Article
Background Most studies on chemsex focus on the health risks associated with the practice, whereas less attention has been paid to the perception of sexual gratification in men who have sex with men (MSM) who use these substances. Aim The purpose of this study was to explore the effects of chemsex substances on sexual response, motivations to engage in chemsex and the relationship with sober sex. Methods Thirty-one Italian cisgender MSM involved in sexualized drug use were interviewed and transcripts were thematically analyzed. Outcomes An ad hoc grid exploring sociodemographic data, chemsex sexual experience, motives, and relationships with sober sex was used during telephone-based interviews. Results Participants showed significant individual differences in how chems may affect their sexual experience. The most reported effects were an increase in sexual desire and subjective arousal, access to higher disinhibition, possible erection and ejaculation difficulties, significant extension of the sexual experience duration, and an intensified perception of intimacy and pleasure. All the positive outcomes of substances on sex creates a great curiosity around chemsex, which is among the primary motives to engage in chemsex for the first time. Over time, other motives may emerge, also connected to substance abuse and craving. Some men reported to be motivated by their partners and friends and to use chemsex to cope with depressive mood/anxiety symptoms, stress and sexual problems. Many differences were reported between chemsex and sober sex. Chemsex seems to embody the idea of transgressive and exciting sex, while sober sex is outlined as a more intimate encounter, that can be significantly affected by performance anxiety. Clinical Translation These results offer some new perspectives that may add interesting information to the literature and be fundamental for future prevention and harm-reduction projects. Strengths & Limitations Although this study is based on a small group of Italian MSM and the interviews were not audio-recorded, transcripts were consistent with scientific literature that considers it important to pay attention to the positive links between sex and substance use. Conclusion The promotion of safer sexual behavior should contemplate an in-depth discussion and recognition of both pleasurable and distressing aspects of chemsex sexual experience, its motivations over time and perceived differences with sober sex. Nimbi FM, Rosati F, Esposito RM, et al. Sex in Chemsex: Sexual Response, Motivations, and Sober Sex in a Group of Italian Men Who Have Sex With Men With Sexualized Drug Use. J Sex Med 2021;XX:XXX–XXX.
... As stressed by Moser (2016), most individuals with paraphilic interests also include genital stimulation and/ or coital intercourse in their sexual behaviors. For example, the majority of BDSM (Bondage-Discipline-Domination/Submission-Sadism/Masochism) practitioners frequently engage (Botta et al., 2019;Connelly, 2006;Gosselin et al., 1991;Moser & Levitt, 1987;Sandnabba et al., 1999) and show interest (Chivers, Roy, Grimbos, Cantor, & Seto, 2014) in non-BDSM and more typical sexual behaviors. A similar diversity of sexual repertoire have been associated in such paraphilias as exhibitionism (Langevin et al., 1979), fetishism (Hawkinson & Zamboni, 2014; c06.indd 94 Rees & Garcia, 2017), zoophilia (Williams & Weinberg, 2003), and necrophilia (Rosman & Resnick, 1989). ...
... In such situations, to avoid any unintended bias, the sample characteristics can be kept in mind while generalizing the research findings. However, the snowball sampling method is often used in modern research literature especially when the topic of research is sensitive and personal references can be useful in bringing large, and otherwise not easily accessible, target samples (Botta et al. 2019;Owojuyigbe et al. 2017). ...
Article
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We conducted four focus group discussions followed by three studies to develop and validate a scale for measuring traditional attitudes toward women in Indian society. Study 1 (n = 592) yielded four factors (i.e., Perceived Feminine Frivolity and Selfishness; Extra-Familial Patriarchal Attitudes; Within-Family Patriarchal Attitudes; Perceived Feminine Weakness) underlying traditional negative attitudes toward women in Indian society. In Study 2 (n = 250), a four-factor reflective model offered a comparatively better model fit and robust psychometric properties for the proposed scale. Study 3 (n = 343) showed that the proposed measure (the Traditional Attitudes toward Indian Women scale; TAIW) explains a significantly greater amount of variance in violent attitudes toward women as compared to a scale standardized in other cultures, demonstrating the predictive relevance of the scale. Decoding the complex relationship between culture and gender-based violence, our measure establishes a clear link between traditional gender and violent attitudes toward women both among male and female participants. We discuss the implication of our findings for policy, research, professional practice, and psychological intervention to create a more inclusive and egalitarian social experience for women.
... The results of the present research specifically document the ways in which sexual motivation can be differentially associated with sexual satisfaction in different relationship contexts, information which is important information for clinicians to have access to so that they may avoid treating CNM individuals from a blanket mononormative perspective (ie, a perspective takes monogamous relationships as the norm and assumes that CNM relationships do not afford similar benefits as monogamous relationships.) Similar to other research focusing on sexual motivations and sexual heath in minority populations (eg, individuals who practice BDSM), 39 this research contributes to a growing body of information documenting clinically-relevant differences and similarities between CNM and monogamous individuals. Having clinicians who are not knowledgeable enough about CNM practices has been associated with early termination of therapy, 38 and a number of couples therapy techniques have also been developed around the notion that men and women have unique sexual motives. ...
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Background Previous research has found differences in sexual motives and, separately, sexual satisfaction in consensually non-monogamous (CNM) and monogamous individuals and that these constructs are related to relationship outcomes (eg, relationship quality). Aims The present study sought to refine and expand on previous research by (i) using a more common, validated measure of sexual motives, (ii) measuring sexual satisfaction with multiple partners within CNM relationships, and (iii) examining how sexual motives are related to sexual satisfaction in CNM relationships. Methods Participants were recruited from a university and using online forums that CNM individuals frequently use (eg, reddit, Facebook). Individuals recruited included those in non-exclusive relationships with one partner (“non-exclusive single-partner;” n = 40), those in non-exclusive relationships with more than one partner (“non-exclusive multipartner;” n = 87), and monogamous individuals (n = 322). Data were analyzed using multivariate analysis of variance and hierarchical multiple regressions. Outcomes The main outcome measures of this study are scores on the Why Humans Have Sex Scale and the New Scale for Sexual Satisfaction. Results Non-exclusive multipartner participants were more motivated to have sex for physical motivations compared with monogamous participants. Although there were no significant differences in sexual satisfaction when comparing monogamous with non-exclusive multipartner participant's secondary and primary partners, unique patterns of sexual motivations were associated with sexual satisfaction based on relationship configuration. Clinical Translation Understanding the unique sexual motives associated with sexual satisfaction in various relationship configurations may help improve clinical approaches to couples counseling for both CNM and non-CNM populations. Strengths and Limitations Data were collected from CNM participants in a variety of relationship configurations and provide analyses comparing primary and secondary partners. However, these results are limited by a small sample of CNM participants who were intentionally recruited from self-identified CNM e-forums. Conclusions These findings add further understanding to the unique traits that characterize CNM individuals and the underlying motivational framework that may encourage individuals to initiate and maintain CNM relationships. Mitchell VE, Mogilski JK, Donaldson SH, et al. Sexual Motivation and Satisfaction Among Consensually Non-Monogamous and Monogamous Individuals. J Sex Med 2020;XX:XXX–XXX.
... The positive relationship between the BDSM subscale and sexual satisfaction for both men and women is also consistent with past research (Botta, Nimbi, Tripodi, Silvaggi, & Simonelli, 2019;Pascoal et al., 2015). These results suggest that arousal from such interests may be healthy and sexually satisfying. ...
Article
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Although paraphilias encompass a broad range of sexual interests, they often are regarded broadly as maladaptive. Doing so, however, may conceal relatively well-adjusted and satisfying forms of sexuality. Participants were recruited through Amazon Mechanical Turk and completed online questionnaires assessing paraphilic interests, sexual satisfaction, resilience, and attachment. Participants were 614 adults, aged 19 to 30years (M=26.08, SD=3.18). Regression analyses demonstrated that atypical paraphilias, paraphilias related to nonconsensual sexual activities, and paraphilias related to BDSM explained a significant proportion of variance in sexual satisfaction. Findings suggest directions on the conceptualization and treatment of paraphilias
... As stressed by Moser (2016), most individuals with paraphilic interests also include genital stimulation and/or coital intercourse in their sexual behaviors. For example, the majority of BDSM (Bondage-Discipline-Domination/Submission-Sadism/Masochism) practitioners frequently engage (Botta, Nimbi, Tripodi, Silvaggi, and Simonelli, 2019;Connelly, 2006;Gosselin & Wilson, 1991;Moser & Levitt, 1987;Sandnabba, Santtila, & Nordling, 1999;Wright 2015) and show interest (Chivers, Roy, Grimbos, Cantor, and Seto, 2014) in non-BDSM and more typical sexual behaviors. A similar diversity of sexual repertoire have been associated in such paraphilias as exhibitionism (Langevin et al., 1979), fetishism (Hawkinson & Zamboni, 2014;Rees & Garcia, 2017), zoophilia (Williams & Weinberg, 2003), and necrophilia (Rosman & Resnick, 1989). ...
Preprint
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This is the preprint version of a chapter published in: L. A. Craig & R. M. Bartels (Eds.) 2021. Sexual Deviance: Understanding and Managing Deviant Sexual Interest and Paraphilic Disorders. Wiley. https://www.wiley.com/en-gb/Sexual+Deviance%3A+Understanding+and+Managing+Deviant+Sexual+Interests+and+Paraphilic+Disorders-p-9781119705833
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BDSM (bondage, discipline, dominance, submission, and sadomasochism) encompasses a diverse set of sexual interests. Research interests in BDSM have been historically underpinned by examining potential mental health issues, unhealthy fixations on specific sexual behaviors, and/or the presence of childhood trauma, as is predicted by psychopathological and psycho-10 analytic models. The objective of this scoping review was to provide an overview of the current landscape of BDSM research, including incidence rates, evidence for psychopathological, psychoanalytical, biological, and social etiological factors, demographics of BDSM practitioners , and the psychological correlates of those with BDSM interests. After the literature search and screening process, 60 articles were included. BDSM related fantasies were found to 15 be common (40-70%) in both males and females, while about 20% reported engaging in BDSM. Results show little support for psychopathologic or psychoanalytic models. In the selected samples studied, BDSM practitioners appear to be white, well educated, young, and do not show higher rates of mental health or relationship problems. Research supports BDSM being used as a broadening of sexual interests and behaviors instead of a fixation on a specific interest. Future 20 empirical research should focus on non-pathological models of BDSM, discrimination of BDSM practitioners, interpersonal relationships, and biological factors.
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The classification of sexual fantasies and behaviors (here referred to as ‘sexual interests’) has historically been divided into ‘paraphilic’ and ‘normophilic’. However, studies on paraphilic interests are often limited to clinical or forensic samples and normophilic interests are rarely assessed in tandem. Previous research has found mixed results for psychological and other correlates of sexual interests, potentially due to inconsistency in operationalism and measurement of fantasies and behaviors. The aim of the current study was to quantify correlates of sexual interests via the Sexual Fantasies and Behaviors Inventory, containing factors related to general fantasies/behaviors, normophilia, power dynamics, sadomasochism, and courtship paraphilias, using a large ( N = 4280) non-clinical sample. Psychological, developmental, sexual, and demographic correlates were investigated via bivariate correlations, mean difference testing, and multiple regression. Sexual interest domains were largely unrelated to psychopathology and developmental factors. Sociosexuality and more accepting attitudes towards sadomasochism was generally related to more arousal to/engagement in normophilic and paraphilic domains. More autism spectrum disorder traits were related to decreased normophilic interests. Psychopathic traits, sexual sensation seeking, and sexual compulsivity were related to paraphilia dimensions, especially courtship paraphilias and domination/sadism; the former was also associated with negative attitudes about establishing consent. Men, non-monogamous, and non-heterosexual participants indicated greater sexual fantasies and behaviors compared to women (except in the case of submission and masochism), monogamous, and heterosexual participants, respectively.
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Recent research has shown that a tendency to harm others goes hand in hand with a tendency to harm oneself. The present two studies further supported the notion that the joy of harming others and oneself has a common core by showing positive relationships between dark personality traits (particularly psychopathy) and sexual masochistic preferences and between general masochistic tendencies and sexual sadistic preferences. Despite the overlap between dark personality traits and general masochistic tendencies, they independently predicted the engagement in sexual sadomasochism. These relationships statistically held when controlling for the impact of basic personality (Study 1). Study 2 found that self-enhancement, openness to change, and low conservation values serve as motivators for a person's attraction to sexual sadomasochism and shed some light on the differences between sexual sadomasochism and the Dark Tetrad. Overall, people who score relatively high on dark personalities and masochism are particularly predisposed to engage in sexual sadomasochism, in both the dominant and the submissive roles.
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Background: A sexual fantasy is a mental thought process which blends with individual’s sexuality and causes sexual excitement. This characteristic connects sexual fantasy more with the sexual and reproductive health of a person. There are differences in the nature and frequency of sexual fantasy experienced by both males and females which are greatly influenced by gender roles and societal forces. Method: A literature review is done using databases “Google Scholar, PubMed, and Medline”. A thorough analysis of the literature was done to extract the most relevant information. Results: The sexual fantasies are divided as typical and atypical. In typical sexual fantasy, all normal imaginations are included such as dominancesubmissiveness, watching pornography, oral and anal sex, and bondage. On the other hand, atypical sexual fantasies include deviant imaginations like paraphilia. Conclusion: While sexual fantasies are of variant types, it was found that these are more commonly reported in Western countries than in the Eastern countries; therefore, there is a growing need to conduct more studies in Eastern countries to better conclude the findings.
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This national web-population study from Norway (N = 4,148) assessed 1) the prevalence of BDSM and role-play interests and behaviors, 2) the socio-demographic characteristics of the BDSM-oriented participants, and 3) the associations between a) BDSM and b) role-play interests and behaviors, and sexual satisfaction, relationship satisfaction, and relationship closeness. Over one in three study participants endorsed at least one BDSM interest or behavior variable. There were no gender nor educational level differences between the BDSM-oriented participants and their traditional "vanilla" (non-BDSM-oriented) counterparts, though BDSM and interests were more common among younger and self-identified LGBQ+ participants. Sexual satisfaction was positively associated with role-play and BDSM behaviors while interest in role-play (but not having previously engaged in it) was negatively associated with this outcome. Lower relationship closeness was associated with an interest in role-play (but not having tried it). No BDSM-related variables were significantly associated with relationship closeness. The findings suggest that BDSM interests and behaviors are relatively common and are linked with sexual and relationship satisfaction.
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Background Unusual sexual interests are largely intercorrelated, yet not much is known about underlying patterns of clusters between various sexual interests. Aim To identify underlying clusters of unusual sexual interests using exploratory factor analysis. Methods We conducted exploratory factor analysis with self-reported interest in a wide variety of unusual sexual acts for an online, international sample (N = 669; 61% female), and for women and men separately. Factor regression weights were correlated to self-reported sex life satisfaction, sexual outlet, and psychiatric symptoms. Outcomes Participants rated the attractiveness of 50 unusual sexual activities, and reported on their sex life satisfaction (Arizona Sexual Experiences Scale), sexual outlet, and symptoms regarding ADHD (Adult ADHD Self-Report Screening Scale for DSM-5), depression, anxiety, and stress (Depression, Anxiety, and Stress Scale). Results We identified 5 factors of unusual sexual interests that were largely comparable for women and men: submission/masochism, forbidden sexual activities, dominance/sadism, mysophilia (attraction to dirtiness or soiled things), and fetishism. For women, unusual sexual interests related to more psychiatric symptoms and higher sexual outlet, whereas this relation was less explicit for men. Clinical Implications Different factors of unusual sexual interests may serve different underlying functions or motivations, for instance related to sexual, and emotional regulation. A better understanding of the nature of unusual sexual interests is important to be able to influence sexual interests that are unwanted or cause damage to others. Strengths & Limitations Strength of this study include its anonymity, the avoidance of sexual orientation effects, and the possibility to indicate only a slight endorsement toward sexual items. Limitations include the sample's generalizability and the truthfulness of online responding. Conclusion Unusual sexual interests could be clustered into 5 factors that were largely comparable for women and men: submission/masochism, forbidden sexual activities, dominance/sadism, mysophilia, and fetishism. Schippers EE, Smid WJ, Huckelba AL, et al. Exploratory Factor Analysis of Unusual Sexual Interests. J Sex Med 2021;XX:XXX–XXX.
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Background Recent research has indicated that participation in BDSM (bondage-discipline, dominance-submission, and/or sadism-masochism) is not associated with psychological distress or psychopathology but that sexual roles may be associated with personality characteristics, specifically interpersonal dominance and empathy. Aim The present study examined potential differences between those who identify as dominant, switch, and submissive on interpersonal dominance and empathy. Methods Individuals who identified as members of the BDSM community were recruited online via a social networking site. Main Outcome Measures Self-reported demographic variables, the Personality Assessment Inventory, Dominance subscale, and the Interpersonal Reactivity Index Empathic Concern subscale. Results Participants were well distributed across sexual roles (n = 279; 25.4% dominant, 38% submissive, 36.6% switch), identified as primarily female (59.5%), primarily heterosexual (53.4%), and the most common age group was 25-34 years (27.2%). BDSM role was associated with scores on the Dominance subscale; dominant BDSM practitioners scored significantly higher on the Dominance scale than switches, who in turn scored significantly higher than submissives (dominant mean [M] = 61.44, standard deviation [SD] = 8.26; switch M = 53.99, SD = 11.18, P < .01; submissive M = 49.41, SD = 11.46, P < .01). There were no differences on the measure of empathy between dominant, submissive, and switch BDSM practitioners. On average, individuals who identified as submissives and switches scored in the average range on the Dominance scale compared with the normative sample, and individuals who identified as dominants scored higher but not in the markedly elevated range. Clinical Implications The study provides information on the relationship between interpersonal dominance as a personality trait and dominance as a sexual role and has implications for reducing stigma related to these practices. Strengths and Limitations The study contributes to the growing literature suggesting that while BDSM roles may correspond with specific personality characteristics, they are not indicative of personalities significantly different than the general population's. The study also included individuals who identified as switch, a group often excluded from quantitative research in the BDSM community. The sample was, however, recruited exclusively online, and findings may not be applicable to all BDSM practitioners. Conclusion These findings suggest that there are no differences in empathy between BDSM practitioner roles, and although there are differences in interpersonal dominance, these characteristics are not likely to be prominent in individuals’ everyday interactions. Jansen KL, Fried AL, Chamberlain J. An Examination of Empathy and Interpersonal Dominance in BDSM Practitioners. J Sex Med 2020;XX:XXX–XXX.
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Background: To date, neither the original English nor any of the translated versions of the Sexual Complaints Screener for Women (SCS-W) have been tested for their psychometric properties. Aim: To evaluate the validity and utility of the German version of the SCS-W by assessing content, convergent, and discriminant validity. Methods: A population sample of 309 women (mean age = 26.9 years) completed the online survey and had matching data available on the SCS-W and the Female Sexual Function Index (FSFI). Spearman bivariate correlations between the SCS-W and FSFI domain scores and exploratory factor analysis with principal component analysis were conducted. Outcomes: Convergent validity was excellent for the domain of orgasm, good for satisfaction, dyspareunia, and the total questionnaire score, and acceptable for desire, lubrication, arousal, and vaginismus. Discriminant validity was present for all domains apart from arousal, lubrication, and vaginismus. Varimax rotation suggested an 8-factor model was the most robust. Clinical implications: This brief screener seems suitable to provide a brief overview of female patients' sexual problems in a clinical setting. Strengths and limitations: This is the 1st study to assess the psychometric properties of the German version of the SCS-W. However, available information on the psychometric properties of the German SCS-W was limited because the validity of the screener could not be counterchecked against a clinical diagnosis of female sexual dysfunction. Conclusion: Our results provide preliminary evidence of good validity of the German version of the SCS-W. Overall, the SCS-W can offer support for clinicians who are less familiar with sexual medicine and who might not routinely discuss sexual issues with their patients. Burri A, Porst H. Preliminary Validation of a German Version of the Sexual Complaints Screener for Women in a Female Population Sample. Sex Med 2018;X:XXX-XXX.
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Background: Bondage and discipline, dominance and submission, and sadism and masochism (BDSM) is gaining popularity through the mainstream media. Nevertheless, very little is known about the prevalence of BDSM-related fantasies and activities in the general population. Aim: To determine the prevalence of BDSM fantasies and behavioral involvement in four different age groups of the general population in Belgium. Methods: By use of a cross-sectional survey questionnaire, the level of interest in several BDSM-related activities was investigated in a sample representative of the general Belgian population (N = 1,027). The questionnaire evaluated interest in 54 BDSM activities and 14 fetishes. Self-identification as BDSM practitioner, situational context of BDSM practice, age at awareness of these interests, and transparency to others were queried. Outcomes: Individual item scores and summary scores on four BDSM categories were included in the analyses. Results: A high interest in BDSM-related activities in the general population was found because 46.8% of the total sample had ever performed at least one BDSM-related activity and an additional 22% indicated having (had) fantasies about it. Interestingly, 12.5% of the total population indicated performing at least one BDSM-related activity on a regular basis. When asked whether they saw themselves as being interested in BDSM, 26% stated this to be the case and 7.6% self-identified as BDSM practitioners. Interests in dominant and submissive activities were comparable and, remarkably, were highly intercorrelated. BDSM and fetish interests were significantly higher in men than in women. The older group (48-65 years) had significantly lower BDSM scores compared with their younger peers. Of participants with a BDSM interest, 61.4% became aware of it before 25 years of age. Clinical implications: There is a high level of interest in BDSM in the general population, which strongly argues against stigmatization and pathologic characterization of these interests. Strengths and limitations: This is the first thorough study concerning prevalence of interest in and fantasies about a wide range of BDSM-related activities in the general population worldwide. Although our findings tend to argue against it, we cannot completely rule out participation bias introduced by non-interest in the non-completers. In addition, some topics might have been subject to interpretation by the respondents. Conclusion: Interest in BDSM is present in most of the general population. Further research is needed to destigmatize it by confirming BDSM as a leisurely preference rather than a psychiatric affliction. Holvoet L, Huys W, Coppens V, et al. Fifty Shades of Belgian Gray: The Prevalence of BDSM-Related Fantasies and Activities in the General Population. J Sex Med 2017;XX:XXX-XXX.
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The sexual double standard is the notion that women are evaluated negatively and men positively for engaging in similar sexual behaviors. Because traditional, gender-based stereotypes are reflected in the attitudes that people hold towards men and women, it is likely that sexism plays a part in the manifestation of the double standard. The goal of the present study is to investigate the relationship between sexism (prejudice against individuals based on their gender) and the sexual double standard. There are two types of sexism: hostile (negative prejudice) and benevolent (positive prejudice). We hypothesized that participants displaying high levels of either type of sexism would be most likely to exhibit the sexual double standard. A US-sample of 232 undergraduates from a Southwestern university completed the Ambivalent Sexism Inventory (ASI) and the Ambivalence Towards Men Inventory (AMI) and then evaluated a hypothetical target individual who reported having zero, one or 12 sexual partners. Results show that participants’ sexist attitudes towards men and women were related to their exhibition of the sexual double standard. Specifically, men and women’s hostile attitudes towards targets of their own gender were related to negative evaluations of highly sexually active targets of the same gender, while men and women’s benevolent attitudes towards the opposite gender were related to positive evaluation of highly sexually active targets of the opposite gender. Implications of the present results and directions for future research are discussed.
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This study explored the role of psychological trait factors in sexual desire and sexual activity. In particular, it investigated how these factors may contribute to maintaining a balance between motivational aspects and self-control abilities, as both have been considered important in relation to adaptive sexuality. Moreover, the study explored the relationship between sexual desire, activity, and satisfaction. Participants completed questionnaires assessing sexual desire (dyadic, solitary), sexual activity (with a partner, alone), sexual satisfaction, approach and avoidance motivation, attachment, self-control, sensation seeking, and mindfulness. Cluster analyses, based on participants' level of sexual desire and sexual activity, highlighted three distinct profiles for each gender related to different types of psychological functioning: (a) participants with high dyadic sexual desire and activity were the most sexually satisfied, showed optimal psychological functioning, and were characterized by a balance between motivational tendencies to seek positive rewards and self-control abilities (high approach motivation, secure attachment, high self-control, high mindfulness); (b) participants with high dyadic and solitary sexual desire and activity were moderately satisfied and showed a type of psychological functioning predominantly characterized by impulsivity (an overly high motivation to obtain rewards in women, and low self-control in men); (c) participants with low dyadic sexual desire and activity were the least sexually satisfied and were characterized by high motivation to avoid negative consequences and low self-control (high avoidance motivation, insecure attachment, and poor mindfulness). These results shed further light on how fundamental psychological factors contribute to explain the individual variability in sexual desire, activity, and satisfaction.
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IntroductionAlthough several theories and treatment plans use unusual sexual fantasies (SF) as a way to identify deviancy, they seldom describe how the fantasies referred to were determined to be unusual.AimThe main goal of this study was to determine which SF are rare, unusual, common, or typical from a statistical point of view among a relatively large sample of adults recruited from the general population. A secondary goal was to provide a statistical comparison of the nature and intensity of sexual fantasies for men and women. This study also aims at demonstrating with both quantitative and qualitative analyses that certain fantasies often considered to be unusual are common.Methods An Internet survey was conducted with 1,516 adults (799 ♀; 717 ♂) who ranked 55 different SF and wrote their own favorite SF. Each SF was rated as statistically rare (2.3% or less), unusual (15.9% or less), common (more than 50%), or typical (more than 84.1% of the sample).Main Outcome MeasuresAn extended version of the Wilson's Sex Fantasy Questionnaire with an open question.ResultsOnly two sexual fantasies were found to be rare for women or men, while nine others were unusual. Thirty sexual fantasies were common for one or both genders, and only five were typical. These results were confirmed with qualitative analyses. Submission and domination themes were not only common for both men and women, but they were also significantly related to each other. Moreover, the presence of a single submissive fantasy was a significant predictor of overall scores for all SF in both genders.Conclusion Care should be taken before labeling an SF as unusual, let alone deviant. It suggested that the focus should be on the effect of a sexual fantasy rather than its content. Joyal CC, Cossette A, and Lapierre V. What exactly is an unusual sexual fantasy? J Sex Med **;**:**–**.
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En el presente estudio teórico se realiza una revisión sistemática de investigaciones publicadas en las que la satisfacción sexual constituye la variable dependiente. Tras una búsqueda bibliográfica en las principales bases de datos electrónicas, y una vez realizado un proceso de selección, se resumen los principales resultados de 197 artículos científicos publicados entre 1979 y 2012. Se comprueba la complejidad y la relevancia de la satisfacción sexual, la cual se asocia con: a) variables individuales, como ciertas características socio-demográficas, psicológicas, así como con el estado de salud físico y psicológico; b) variables vinculadas con la relación de pareja y con la respuesta sexual; c) factores relacionados con el apoyo social y relaciones familiares; y d) creencias y valores culturales como la religión. Como conclusión se puede señalar que la satisfacción sexual constituye un factor clave, tanto de la salud sexual como del bienestar general de las personas. No obstante, a pesar de su relevancia, se echan en falta modelos teóricos que aúnen los factores más importantes en la explicación de la satisfacción sexual.
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Social scripting theory points to the fact that much of sexual behavior seems to follow a script. Similar to scripts that stage actors use to guide their behavior, social scripts instruct members of a society as to appropriate behavior and the meanings to attach to certain behaviors. In Western cultures, scripts for sexual activity are markedly different for males and females. In this article, the goals are to provide (a) an introduction to social scripting theory, (b) an exploration of the ways and potential reasons sexual scripts differ by gender, and (c) a discussion of ways that a social scripting perspective can be applied to work with individuals and couples experiencing sexual problems.
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This is a qualitative investigation of 73 individuals in the Bondage and Discipline, Dominance and Submission, and Sado-Masochism subculture. There is tremendous stigma attached to this subculture, and while the academic community may be increasingly accepting, the general public is not as accepting or knowledgeable. Fear of negative consequences means that many engage in secrecy and concealment strategies as protective measures. Although there is much literature on the possible consequences and the reasons for concealment, there remain gaps. Our findings reveal how many conceal to cover up or to hide what outsiders may consider immoral or otherwise unacceptable behavior. Others conceal as a means to create a distinction for themselves as part of a secret subculture. Whatever their reasons, those in this subculture engage in a variety of strategies to manage their identity and to minimize their vulnerability.
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It has been generally thought that the practice of bondage-discipline, dominance-submission, sadism-masochism (BDSM) is in some form associated with psychopathology. However, several more recent studies suggest a relative good psychological health of BDSM practitioners. The aim of this study was to compare scores of BDSM practitioners and a control group on various fundamental psychological characteristics. For this aim, 902 BDSM and 434 control participants completely filled out online questionnaires. Associations were examined using χ2 tests of independence with φ and Cramer's V as effect size measures and eta or Pearson's correlation. Group differences were tested using analysis of covariance, with partial η2 as effect size measure. A priori contrasts were tested using α = 0.01 to correct for multiple testing; for all other tests we used α = 0.05, two tailed. The study used Big Five personality dimensions (NEO Five-Factor Inventory), attachment styles (Attachment Styles Questionnaire), rejection sensitivity (Rejection Sensitivity Questionnaire), and subjective well-being (World Health Organization-Five Well-being Index). The results mostly suggest favorable psychological characteristics of BDSM practitioners compared with the control group; BDSM practitioners were less neurotic, more extraverted, more open to new experiences, more conscientious, less rejection sensitive, had higher subjective well-being, yet were less agreeable. Comparing the four groups, if differences were observed, BDSM scores were generally more favorably for those with a dominant than a submissive role, with least favorable scores for controls. We conclude that BDSM may be thought of as a recreational leisure, rather than the expression of psychopathological processes. Wismeijer AAJ and van Assen MALM. Psychological characteristics of BDSM practitioners. J Sex Med 2013;10:1943–1952.
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Sexual script research (Simon & Gagnon 196950. Simon , W. , & Gagnon , J. H. ( 1969 ). Psychosexual development . Society , 6 ( 5 ), 9 – 17 . doi: 10.1007/BF02806366 [CrossRef]View all references, 198652. Simon , W. , & Gagnon , J. H. ( 1986 ). Sexual scripts: Permanence and change . Archives of Sexual Behavior , 15 ( 2 ), 97 – 120 . doi: 10.1007/BF01542219 [CrossRef], [PubMed], [Web of Science ®], [CSA]View all references) bourgeoned following Simon and Gagnon's groundbreaking work. Empirical measurement of sexual script adherence has been limited, however, as no measures exist that have undergone rigorous development and validation. We conducted three studies to examine current dominant sexual scripts of heterosexual adults and to develop a measure of endorsement of these scripts. In Study 1, we conducted three focus groups of men (n = 19) and four of women (n = 20) to discuss the current scripts governing sexual behavior. Results supported scripts for sex drive, physical and emotional sex, sexual performance, initiation and gatekeeping, and evaluation of sexual others. In Study 2, we used these qualitative findings to develop a measure of script endorsement, the Sexual Script Scale. Factor analysis of data from 721 participants revealed six interrelated factors demonstrating initial construct validity. In Study 3, confirmatory factor analysis of a separate sample of 289 participants supported the model from Study 2, and evidence of factorial invariance and test-retest reliability was obtained. This article presents the results of these studies, documenting the process of scale development from formative research through to confirmatory testing, and suggests future directions for the continued development of sexual scripting theory.
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The association between cognitive schemas activated during sexual events and sexual functioning was studied. A total of 376 participants (47 women and 49 men with a DSM-IV diagnosis of sexual dysfunction and 160 women and 120 men from a control group) answered the Questionnaire of Cognitive Schema Activation in Sexual Context, the International Index of Erectile Function, and the Female Sexual Function Index. Results showed that participants with sexual dysfunction activated significantly more negative schemas when exposed to sexually unsuccessful situations compared to sexually healthy individuals (after controlling for the frequency of negative sexual events experienced by both groups). Most men and women with sexual difficulties interpreted negative sexual events according to an incompetence self-schema (I'm powerless, I'm incompetent, I'm a failure). These findings were congruent with recent research indicating the tendency shown by individuals with sexual dysfunction to give attributions of an internal, stable, and global nature to negative sexual experiences. Overall, results suggest specific faulty cognitive constructions underlying sexual dysfunctions and encourage the development of models and treatment approaches based on cognitive theory.
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The true prevalence of sexual sadism (and its variants) is unknown. However, all clinicians will knowingly or unknowingly encounter patients with this disorder. Regretfully, few programs offer adequate education in normal sexuality and even less provide training in the assessment and treatment of pathologic sexual interests. This review synthesizes current theories about possible etiologies of criminal sexual sadism and the resulting implications for diagnosis and treatment of this sexual disorder. Included is a review of theories of criminally sadistic sexual motivations, response patterns, and physiology, including possible neurophysiologic factors and more complex interactions. This review focuses primarily on published English-language scientific studies of sexual sadism. It should be noted that my use of the term sadism refers to nonconsensual sexual aggression.
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There is a concern among consensual BDSM participants that they will receive biased care from mental health professionals. Results are presented of an anonymous Internet-based survey administered to both BDSM-identified individuals who have received psychological care and to mental health professionals. The survey included socio-demographic data and invited participants to write narrative accounts of biased or culturally sensitive care, from which common themes were identified. Mental health providers (N=17) responded in fewer numbers than those who identified as BDSM-identified participants (N=175). Descriptive characteristics of the sample will be discussed. Themes from the qualitative data may be useful in informing the future development of guidelines for practitioners to work more responsibly with clients who identify as members of this sexual minority group.
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People with sexual interests in bondage and discipline, "sadomasochism" or dominance and submission (BDSM) have been seen by many professionals as damaged or dangerous. To examine sexual behavior correlates of involvement in BDSM and test the hypothesis that BDSM is practiced by people with a history of sexual coercion, sexual difficulties, and/or psychological problems. In Australia in 2001-2002, a representative sample of 19,307 respondents aged 16-59 years was interviewed by telephone. Weighted data analysis used univariate logistic regression. Self-reported demographic and psychosocial factors; sexual behavior and identity; sexual difficulties. In total, 1.8% of sexually active people (2.2% of men, 1.3% of women) said they had been involved in BDSM in the previous year. This was more common among gay/lesbian and bisexual people. People who had engaged in BDSM were more likely to have experienced oral sex and/or anal sex, to have had more than one partner in the past year, to have had sex with someone other than their regular partner, and to have: taken part in phone sex, visited an Internet sex site, viewed an X-rated (pornographic) film or video, used a sex toy, had group sex, or taken part in manual stimulation of the anus, fisting or rimming. However, they were no more likely to have been coerced into sexual activity, and were not significantly more likely to be unhappy or anxious-indeed, men who had engaged in BDSM scored significantly lower on a scale of psychological distress than other men. Engagement in BDSM was not significantly related to any sexual difficulties. Our findings support the idea that BDSM is simply a sexual interest or subculture attractive to a minority, and for most participants not a pathological symptom of past abuse or difficulty with "normal" sex.
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In two studies, 58 sadomasochistic (SM) practitioners provided physiological measures of salivary cortisol and testosterone (hormones associated with stress and dominance, respectively) and psychological measures of relationship closeness before and after participating in SM activities. Observed activities included bondage, sensory deprivation, a variety of painful and pleasurable stimulation, verbal and non-verbal communication, and expressions of caring and affection. During the scenes, cortisol rose significantly for participants who were bound, receiving stimulation, and following orders, but not for participants who were providing stimulation, orders, or structure. Female participants who were bound, receiving stimulation, and following orders also showed increases in testosterone during the scenes. Thereafter, participants who reported that their SM activities went well showed reductions in physiological stress (cortisol) and increases in relationship closeness. Among participants who reported that their SM activities went poorly, some showed decreases in relationship closeness whereas others showed increases. The increases in relationship closeness combined with the displays of caring and affection observed as part of the SM activities offer support for the modern view that SM, when performed consensually, has the potential to increase intimacy between participants.
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Background: The Sexual Modes Questionnaire (SMQ) is a validated and widespread used tool to assess the association among negative automatic thoughts, emotions, and sexual response during sexual activity in men and women. Aim: To test the psychometric characteristics of the Italian version of the SMQ focusing on the Automatic Thoughts subscale (SMQ-AT). Methods: After linguistic translation, the psychometric properties (internal consistency, construct, and discriminant validity) were evaluated. 1,051 participants (425 men and 626 women, 776 healthy and 275 clinical groups complaining about sexual problems) participated in the present study. Outcomes: 2 confirmatory factor analyses were conducted to test the fit of the original factor structures of the SMQ versions. In addition, 2 principal component analyses were performed to highlight 2 new factorial structures that were further validated with confirmatory factor analyses. Cronbach α and composite reliability were used as internal consistency measures and differences between clinical and control groups were run to test the discriminant validity for the male and female versions. The associations with emotions and sexual functioning measures also are reported. Results: Principal component analyses identified 5 factors in the male version: erection concerns thoughts, lack of erotic thoughts, age- and body-related thoughts, negative thoughts toward sex, and worries about partner's evaluation and failure anticipation thoughts. In the female version 6 factors were found: sexual abuse thoughts, lack of erotic thoughts, low self-body image thoughts, failure and disengagement thoughts, sexual passivity and control, and partner's lack of affection. Confirmatory factor analysis supported the adequacy of the factor structure for men and women. Moreover, the SMQ showed a strong association with emotional response and sexual functioning, differentiating between clinical and control groups. Clinical translation: This measure is useful to evaluate patients and design interventions focused on negative automatic thoughts during sexual activity and to develop multicultural research. Strengths and limitations: This study reports on the translation and validation of the Italian version of a clinically useful and widely used measure (assessing automatic thoughts during sexual activity). Limits regarding sampling technique and use of the Automatic Thoughts subscale are discussed in the article. Conclusion: The present findings support the validity and the internal consistency of the Italian version of the SMQ-AT and allow the assessment of negative automatic thoughts during sexual activity for clinical and research purposes. Nimbi FM, Tripodi F, Simonelli C, Nobre P. Sexual Modes Questionnaire (SMQ): Translation and Psychometric Properties of the Italian Version of the Automatic Thought Scale. J Sex Med 2018;XX:XXX-XXX.
Article
Background: The literature lacks studies of the male sex drive. Most existing studies have focused on hypoactive sexual desire disorder in coupled heterosexual men, highlighting some of the main related biological, psychological, and social factors. Aim: To evaluate the role of selected psychological and social variables affecting male sexual desire such as quality of life, sexual function, distress, satisfaction, psychological symptoms, emotions, alexithymia, couple adjustment, sexism, cognitive schemas activated in a sexual context, sexual dysfunctional beliefs, and different classes of cognitions triggered during sexual activity about failure anticipation, erection concerns, age- and body-related thoughts, erotic fantasies, and negative attitudes toward sexuality. Methods: A wide self-administered survey used snowball sampling to reach 298 heterosexual Italian men (age = 32.66 ± 11.52 years) from the general population. Outcomes: 13 questionnaires exploring psychological and social elements involved in sexual response were administrated: International Index of Erectile Function, Short Form 36 for Quality of Life, Beck Depression Inventory-II, Symptom Check List-90-Revised, Toronto Alexithymia Scale, Premature Ejaculation Severity Index, Sexual Distress Scale, Sexual Satisfaction Scale, Dyadic Adjustment Scale, Ambivalent Sexism Inventory, Sexual Modes Questionnaire, Sexual Dysfunctional Belief Questionnaire, and Questionnaire of Cognitive Schema Activation in Sexual Context. Results: Results showed lack of erotic thoughts (β = -0.328), fear (β = -0.259) and desire to have a baby (β = -0.259) as the main predictors of the level of sexual desire in this group. Energy-fatigue, depression, premature ejaculation severity, sexual distress, compatibility, subjective sexual response, and sexual conservatism had a weaker effect on sexual desire. Sexual functioning (13.80%), emotional response (12.70%), dysfunctional sexual beliefs (12.10%), and negative automatic thoughts (12.00%) had more variable effects on sexual drive. Clinical translation: Analyzed variables could represent important factors that should be considered in the assessment of desire concerns and discussed in therapy. Strengths and limitations: The strength of this study is the analysis of novel psychological and social factors on male sexual desire. Recruitment and sample size do not allow generalization of the results, but some crucial points for future research and clinical practice are discussed. Conclusion: Our findings showed that male sexual desire could be affected by many psychological and social elements. Other factors remain to be explored, in their direct and interactive effects, aiming to better explain male sexual desire functioning. Nimbi FM, Tripodi F, Rossi R, Simonelli C. Expanding the Analysis of Psychosocial Factors of Sexual Desire in Men. J Sex Med 2017;XX:XXX-XXX.
Article
Bondage-discipline/Dominance-submission/sadomasochism (BDSM) is an often misunderstood and misrepresented social phenomenon warranting further discourse and study. Community-based research that engages member perspective can assist in understanding socially marginalized experiences. The current study examined the role, meaning, and function of BDSM communities from the perspective of self-identified members. Seven nominal group technique workshops were conducted representing a variety of practitioner experiences and identities. Workshops involved 48 participants and resulted in the generation of 133 unique terms describing the role of BDSM communities in their lives. Terms were coded using a five-step procedure involving both academic and community members. A total of 15 categories were identified and included domains such as acceptance, sexual expression, friendship, safety, and sharing of educational knowledge. Results underscore the multifaceted nature of the role of such communities. While results consisted of mostly positive features, participants also identified certain negative aspects, such as conflict among members. Results from the study provide a succinct, member-derived, structured inventory of the role of BDSM communities that can serve to validate and synthesize existing research, improve dissemination of community voice around BDSM, and inform future research. We conclude with a discussion of the study's implications for sex education, clinical practice, and community dissemination.
Article
Research in various populations has shown that, starting early in childhood, individuals often demonstrate resilience in the face of stress and adversity. Against the experience of minority stress, LGBT people mount coping responses and most survive and even thrive despite stress. But research on resilience in LGBT populations has lagged. In this commentary, I address 2 broad issues that I have found wanting of special exploration in LGBT research on resilience: First, I note that resilience, like coping, is inherently related to minority stress in that it is an element of the stress model. Understanding resilience as a partner in the stress to illness causal chain is essential for LGBT health research. Second, I explore individual- versus community-based resilience in the context of minority stress. Although individual and community resilience should be seen as part of a continuum of resilience, it is important to recognize the significance of community resilience in the context of minority stress.
Article
Introduction: Little attention has been paid to distress in sexual functioning or the sexual satisfaction of people who practice BDSM (Bondage and Discipline, Domination and Submission, Sadism and Masochism). Aim: The purpose of this study was to describe sociodemographic characteristics and BDSM practices and compare BDSM practitioners' sexual outcomes (in BDSM and non-BDSM contexts). Methods: A convenience sample of 68 respondents completed an online survey that used a participatory research framework. Cronbach's alpha and average inter-item correlations assessed scale reliability, and the Wilcoxon paired samples test compared the total scores between BDSM and non-BDSM contexts separately for men and women. Open-ended questions about BDSM sexual practices were coded using a preexisting thematic tree. Main outcome measures: We used self-reported demographic factors, including age at the onset of BDSM interest, age at first BDSM experience, and favorite and most frequent BDSM practices. The Global Measure of Sexual Satisfaction measured the amount of sexual distress, including low desire, arousal, maintaining arousal, premature orgasm, and anorgasmia. Results: The participants had an average age of 33.15 years old and were highly educated and waited 6 years after becoming interested in BDSM to act on their interests. The practices in which the participants most frequently engaged did not coincide with the practices in which they were most interested and were overwhelmingly conducted at home. Comparisons between genders in terms of distress in sexual functioning in BDSM and non-BDSM contexts demonstrate that, with the exception of maintaining arousal, we found distress in sexual functioning to be statistically the same in BDSM and non-BDSM contexts for women. For men, we found that distress in sexual functioning, with the exception of premature orgasm and anorgasmia, was statistically significantly lower in the BDSM context. There were no differences in sexual satisfaction between BDSM and non-BDSM contexts for men or women. Conclusion: Our findings suggest that BDSM sexual activity should be addressed in clinical settings that account for BDSM identities, practices, relationships, preferences, sexual satisfaction, and distress in sexual function for men and women. Additional research needs are identified, such as the need to define distressful sexual functioning experiences and expand our understanding of the development of BDSM sexual identities.
Article
The current research reports a dyadic analysis of sexual satisfaction, relationship happiness, and correlates of these couple outcomes in a large multinational dataset consisting of 1,009 midlife heterosexual couples (2,018 individuals) recruited in Japan, Brazil, Germany, Spain, and the United States (Heiman et al., 2011). Actor-Partner Interdependence Models (Kenny, Kashy, & Cook, 2006) identified correlates of sexual satisfaction that included individuals' reports of good health; frequent kissing, cuddling, and caressing; frequent recent sexual activity; attaching importance to one's own and one's partner's orgasm; better sexual functioning; and greater relationship happiness. Even after controlling for individual-level effects, partners' reports of good health; frequent kissing, cuddling, and caressing; frequent recent sexual activity; attaching importance to one's own and one's partner's orgasm; better sexual functioning; and greater relationship happiness contributed significantly to predicting and understanding individuals' sexual satisfaction. Correlates of relationship happiness included individuals' reports of good health; frequent kissing, cuddling, and caressing; frequent recent sexual activity; attaching importance to one's own and one's partner's orgasm; better sexual functioning; and greater sexual satisfaction, and once again, even after controlling for individual-level effects, partners' reports of each of these correlates contributed significantly to predicting and understanding individuals' relationship happiness. Interactions of individual and partner effects with participant gender are also reported. Current results demonstrate empirically that the partner "matters" to an individual's sexual satisfaction and relationship happiness and indicate that a comprehensive understanding of factors contributing to these couple outcomes requires a couple-level research strategy. Partner effects, even when controlling for individual effects, were consistently observed, and explanation of sexual satisfaction and relationship happiness always depended on identifying and understanding mutual and concurrent individual and partner influences.
Article
A demographic questionnaire and 7 psychometric tests were administered to 32 self-identified Bondage/Domination/SadoMasochism (BDSM) practitioners. Although psychoanalytic literature suggests that high levels of certain types of psychopathology should be prevalent among BDSM practitioners, this sample failed to produce widespread, high levels of psychopathology on psychometric measures of depression, anxiety, obsessive-compulsion, psychological sadism, psychological masochism, or PTSD. In fact, on measures of clinical psychopathology and severe personality pathology, this sample appeared to be comparable to both published test norms and to DSM-IV-TR estimates for the general population. There were, however, some exceptions to this general pattern, most notably the higher-than-average levels of narcissism and nonspecific dissociative symptoms found in the sample. This study also raises significant concern about the appropriateness of the diagnosis of sexual masochism and sadism in the Diagnostic and Statistical Manual of the American Psychiatric Association or, minimally, the diagnostic criteria of these disorders.
Article
The purpose of this research was to explore essentialist and constructionist accounts within BDSM (bondage and discipline, dominance and submission, and sadism and masochism) practitioners’ stories about their first attraction to this sexuality. Whereas prior research has examined the ‘coming out stories’ of other sexual minorities (lesbian, gay and bisexual (LGB) individuals and polyamorous individuals), little scholarly attention has been paid to narratives of initial interest in BDSM. A total of 144 women and 128 men who self-identified as being involved in BDSM responded to a questionnaire that included the open-ended item ‘What first attracted you to BDSM? Please describe the reasons why you first became interested in BDSM as a sexual practice or orientation’. Using thematic analysis, we identified two mutually exclusive explanations for initial BDSM interests: (1) BDSM interests are an intrinsic part of the self and (2) BDSM interests developed because of external influences. Analyses revealed very few differences in the endorsement of these themes by either gender or BDSM role. The only gender differences found were among submissive participants: a greater proportion of men than women cited ‘intrinsic self’, whereas a greater proportion of women than men cited ‘external influences’. Additionally, a small number of participants (primarily women and primarily submissives) described a ‘socialised essentialism’, in which external influences initially brought them to BDSM, but these interests were then experienced as an essential part of themselves. We discuss these findings in relation to prior research on the meanings of BDSM practice for participants, in terms of current theorising about the role of stories in the development of one's sexual self, and in relation to essentialist, constructionist and dynamical theories of sexual identity development.
Article
Participants in alternative or ‘kinky’ sexual behaviours are a sizable enough minority that psychotherapists are likely to see them in their practices. However, those who engage in bondage and discipline (BD), dominance and submission (DS) and sadism and masochism (SM) (BDSM) are concerned that mental health-care providers will view BDSM as evidence of psychopathology. This research employed an Internet-based survey of 766 therapists in the United States to assess therapists' attitudes towards the BDSM community. Seventy-six per cent of the sample reported having treated at least one client who engaged in BDSM, although only 48% perceived themselves to be competent in this area. Attitudes towards BDSM were related to socio-demographic variables and self-perceived competence.
Article
Tomkins' (1979) script theory offers a coherent, heuristic, and elegant account of the macho personality constellation (Mosher & Sirkin, 1984), consisting of: (a) callous sexual attitudes, (b) violence as manly, and (c) danger as exciting. A script is a set of rules for interpreting, directing, defending, and creating the scenes making up the life of the macho man. The macho script organizes childhood scenes in which so‐called “superior, masculine” affects—like excitement and anger—were socialized to be favored over so‐called “inferior, feminine” affects—like distress and fear. Furthermore, both adolescent rites of passage in male youth social networks and processes of enculturation in the American culture and its mass media continue that hypermasculine socialization. The ideological script of machismo descends from the ideology of the warrior and the stratifications following warfare—victor and vanquished, master and slave, the head of the house and woman as his complement, the patriarch and his children. The personality script of the macho man and his ideology of machismo mutually amplify one another —simultaneously justifying his lifestyle and celebrating his world view. In his dangerous, adversarial world of scarce resources, his violent, sexually callous, and dangerous physical acts express his “manly” essence.
Article
Conflicts and cooperation offer two kinds of surprises: ition, mathematical analysis shows that the use of rea- those generated by a participant and those generated by sonable and traditional rules of thumb can lead to sur- the situation. Surprises of the first kind are familiar. For prising results for all participants. Mathematical analyses example, in The Art of War (1521), the Florentine bureau- of these models appear elsewhere. Here I describe only crat Niccolb Machiavelli counseled military commanders the models and their properties. to surprise their opponents; he gave many historical Because the training and intuition of different peo- examples of such surprises. How best to achieve surprise ple are different, one person's surprise is often another in political and military conflicts is person's so-what. In the examples
Article
Whereas gendered sexual scripts are hegemonic at the cultural level, research suggests they may be less so at dyadic and individual levels. Understanding "disjunctures" between sexual scripts at different levels holds promise for illuminating mechanisms through which sexual scripts can change. Through interviews with 44 heterosexually active men and women aged 18 to 25, the ways young people grappled with culture-level scripts for sexuality and relationships were delineated. Findings suggest that, although most participants' culture-level gender scripts for behavior in sexual relationships were congruent with descriptions of traditional masculine and feminine sexuality, there was heterogeneity in how or whether these scripts were incorporated into individual relationships. Specifically, three styles of working with sexual scripts were found: conforming, in which personal gender scripts for sexual behavior overlapped with traditional scripts; exception-finding, in which interviewees accepted culture-level gender scripts as a reality, but created exceptions to gender rules for themselves; and transforming, in which participants either attempted to remake culture-level gender scripts or interpreted their own nontraditional styles as equally normative. Changing sexual scripts can potentially contribute to decreased gender inequity in the sexual realm and to increased opportunities for sexual satisfaction, safety, and well-being, particularly for women, but for men as well.
Article
The challenge in the field of sexual medicine is to develop evidence-based principles for clinical evaluation and create a uniform, widely accepted diagnostic and treatment approach for all sexual problems and dysfunctions, for both genders. To provide recommendations for the broad approach for assessing sexual problems in a medical practice setting; to develop an evidence-based diagnostic and treatment algorithm for men and women with sexual dysfunctions. The PubMed literature was reviewed. Expert opinion was based on the grading of evidence-based medical literature and the Delphi consensus process. The Committee determined three principles for clinical evaluation and management: (i) adoption of a patient-centered framework, with emphasis on cultural competence in clinical practice; (ii) application of evidence-based medicine in diagnostic and treatment planning; (iii) use of a unified management approach in evaluating and treating sexual problems in both men and women. The International Consultation in Sexual Medicine-5 stepwise diagnostic and treatment algorithm was developed for that purpose. According to this algorithm, sexual, medical, and psychosocial history is mandatory, whereas physical examination and laboratory tests are highly recommended in most cases. Furthermore, the Brief Sexual Symptom Checklist (BSSC) for Men and BSSC for Women, and more recently the Sexual Complaints Screener (SCS) for Men and SCS for Women, were all endorsed for screening purposes. A classification system was also defined; clinically, sexual dysfunctions are categorized in three types according to their etiology (Type I: psychogenic; Type II: organic; Type III: mixed). Final recommendations on specialized diagnostic tests were based on level of evidence. A unified diagnostic and management strategy in sexual medicine, irrespective of condition and gender, would improve patients' sexual well-being. It would also lead to the development of academic curricula to provide practicing physicians across specialties with the needed skills to meet contemporary patients' needs in sexual medicine health-care delivery.
Article
A general introduction to scripting theory is offered, attempting to provide links between macrolevel considerations of sociocultural development and general theories of individual development. The scripting of behavior is examined on three distinct levels: cultural scenarios (instruction in collective meanings), interpersonal scripts (the application of specific cultural scenarios by a specific individual in a specific social context), and intrapsychic scripts (the management of desires as experienced by the individual). These concepts of the scripting of behavior are then applied to sexual behavior. Interpersonal scripts are seen as the ordering of representations of self and other that facilitate the occurrence of a sexual act; intrapsychic scripts represent the ordering of images and desires that elicit and sustain sexual arousal. Issues of stability and change in sexual scripts are then examined in terms of the changing circumstances and requirements associated with movement through the life cycle.
Feeling queer of queer feelings: Radical approaches to Counselling sex, sexualities, and genders
  • M Barker
  • A Iantaffi
  • C Gupta
Barker M, Iantaffi A, Gupta C. Kinky clients, kinky counselling? The challenges and potentials of BDSM. In: Moon L, ed. Feeling queer of queer feelings: Radical approaches to Counselling sex, sexualities, and genders. London, UK: Routledge; 2007. p. 106-124.
Taking sides: Clashing views in human sexuality
  • W Pawlowski
  • Bdsm
Pawlowski W. BDSM: The ultimate expression of healthy sexuality. In: Taverner WJ, McKee RW, eds. Taking sides: Clashing views in human sexuality. New York, NY: McGraw-Hill; 2009. p. 70-75.
Sexual Dysfunctional Beliefs Questionnaire (SDBQ): Translation and psychometric properties of the Italian version
  • F M Nimbi
  • F Tripodi
  • C Simonelli
Nimbi FM, Tripodi F, Simonelli C, et al. Sexual Dysfunctional Beliefs Questionnaire (SDBQ): Translation and psychometric properties of the Italian version. Sexologies. https://doi.org/10.1 016/j.sexol.2018.09.003. E-pub ahead of print.
Sexual disorders and sexual health in the ICD-11: Parallels and contrasts with DSM-5 paraphilic disorders
  • R B Krueger
Krueger RB. Sexual disorders and sexual health in the ICD-11: Parallels and contrasts with DSM-5 paraphilic disorders. Paper presented at: the 2013 Annual Meeting of the American Psychiatric Association. May 18e22, 2013; San Francisco, CA.
Pressemelding fra Helsedirektoratet 1.2.2010 [The Norwegian Directorate of Health takes sexual minorities off the sick list. Press release from the Directorate of Health
  • Helsedirektoratet Friskmelder Seksuelle
  • Minoriteter
Helsedirektoratet friskmelder seksuelle minoriteter. Pressemelding fra Helsedirektoratet 1.2.2010 [The Norwegian Directorate of Health takes sexual minorities off the sick list. Press release from the Directorate of Health February 1, 2010];
Sexual minorities: Fetishists and sadomasochists included in the Directorate of Health' official list of sexual minorities
  • Helsedirektoratet Seksuelle Minoriteter
Helsedirektoratet Seksuelle minoriteter [Sexual minorities: Fetishists and sadomasochists included in the Directorate of Health' official list of sexual minorities];
Understanding sadomasochism: An empirical examination of four perspectives
  • P A Cross
  • K Matheson
Cross PA, Matheson K. Understanding sadomasochism: An empirical examination of four perspectives. J Homosex 2006; 50:133-166.